Medication side effects are the #4 leading cause of death in the U.S. annually (JAMA 1998). Yet, few people receive adequate information when medication is prescribed. This website is dedicated to providing information to help you and your doctor make informed, intelligent choices about medications and natural alternatives to maximize the benefits and minimize the risks of treatment. Note: This website is free of drug company or government influence. Jay S. Cohen M.D.

Chocolate: A Health Food?

I'm a chocolaholic. I've been
a lover of chocolate in its myriad forms from before I can remember. As a
kid, it didn't get any better than a box of chocolate chip cookies and a glass
of milk. So I was intrigued by recent articles about chocolate's newly discovered
health benefits. I'd certainly like to believe that chocolate is good for
me. And why not? Even Andrew Weil recommends dark chocolate.

grabbing stories in 2002 about chocolate's
new-found health benefits stemmed from a study in the American Journal
of Clinical Nutrition.1 The study was
small, comprising only 23 subjects, and it was funded by the American Cocoa
Research Institute. The abstract (summary) of the article, which is what most
people read, stated that cocoa and chocolate, when added to a healthy diet,
provided antioxidant benefits and increased the good HDL (high density lipoprotein)
cholesterol. One antioxidant benefit was to impede the harmful, atherosclerosis-accelerating
oxidation of LDL (low density lipoprotein cholesterol, the bad cholesterol).
These were the findings that the media trumpeted.

But a closer look at the article wasn't quite
as encouraging. The authors acknowledged that the beneficial effects from
chocolate were small at best. "It is important to note that the clinical
significance of these small differences in indexes of oxidation status remain
to be clarified." Meaning that the small differences might have no significance
at all. And regarding the so-called benefits of increasing HDL, these weren't
significant, as the researchers noted: "the cocoa-chocolate diet had
neutral effects on lipids and lipoproteins."

"I'd certainly
like to believe that chocolate is good for me.
And why not? Even Andrew Weil says so."

In fact, as if anticipating that
this study might be over-hyped, the journal headed the issue with an editorial
to put the findings in perspective. In "How good is chocolate?"
nutrition expert Paul Nestel noted that plants supply many thousands of healthful
substances to the human diet. It is well known that soy, grapes, tea, onions,
apples, citrus and many others are rich sources of antioxidants, so it's not
surprising that cocoa contains an antioxidant, too. How important is the antioxidant
in chocolate? Nestel questioned the importance of chocolate's modest effects
on LDL oxidation. He further asked, "Given that there are thousands of
flavonoids in the foods that we eat ... should each new finding be greeted
as an encouragement to eat that particular source because it contains a special
flavonoid?" 2

"Unfortunately
for chocolate lovers, chocolate's high content of stearic acid puts it in
the same category of risk of coronary disease as meat and butter -- i.e.,
pathogenic!" -- American Journal of Clinical Nutrition

Also not mentioned
was that chocolate contains a high amount of stearic acid, a saturated fat,
and saturated fats are directly linked to elevated LDL cholesterol levels
and to increased risks of coronary artery disease and coronary death. Chocolate
supporters claim that stearic acid isn't like other saturated fats. Yet, in
the Nurses' Health Study Involving more than 80,000 women over 14 years, the
saturated fat in chocolate was shown to increase the risk of coronary heart
disease by as much or even more than other, proven-harmful saturated fats.3

Stearic acid also appears to reduce the protective
HDL and may increase tendencies toward fibrin and plaque deposition in the
development of atherosclerosis. Based on these and other findings, a 1999
editorial in the American Journal of Clinical Nutrition concluded:
"Unfortunately for chocolate lovers, chocolate's high content of stearic
acid puts it in the same category of risk of coronary disease as meat and
butter -- i.e., pathogenic!"4

Let's put chocolate's "benefits" into perspective.
First, you can get similar antioxidants from almost any other plant-based
foods. Vegetables, fruits, and whole grains are much better sources of antioxidants,
and also contain many other healthful nutrients. And unlike chocolate, they
won't increase your waistline with extra calories from sugar and fat.
Just three ounces of Toll House semi-sweet chocolate
contain 420 calories, 210 (50%) from fat and 168 (40%) from sugar. And the
saturated fat and simple sugar in chocolate are the kinds you want to avoid
the most. Indeed, even if cocoa contains some healthful flavonoids, only 10%
of the calories of Toll House semi-sweet chocolate come from cocoa. The rest
is junk.

Food industry-funded studies notwithstanding, the
bottom line on chocolate is this: Chocolate is a terrific food, but it
isn't a health food. Use chocolate -- dark chocolate, not milk chocolate
-- in moderation. Dr. Stephen Sinatra, who is a cardiologist, a colleague,
and also a chocolate lover, suggests one ounce of dark chocolate a few times
a week. I can live with that.

One ounce of dark chocolate three times a week.
Stephen Sinatra, M.D., cardiologist.
In fact, you can indulge yourself a lot more by using products and recipes
that combine cocoa with healthier fats and sweeteners rather than manufactured
chocolates. The food industry should work on this. Providing "healthy
chocolate" made of cocoa and healthy ingredients would tap a big market
of health-conscious chocolate lovers like me. Maybe then I could write a truly
enthusiastic article about chocolate.

NOTE TO READERS: The purpose of this E-Letter is solely informational and educational. Theinformation herein should not be considered to be a substitute forthe direct medical advice of your doctor, nor is it meant to encourage the diagnosis or treatment of any illness, disease, or other medical problem by laypersons. If you are under a physician's care for any condition, he or she can advise you whether the information in this E-Letter is suitable for you. Readers should not make any changes in drugs, doses, or any other aspects of their medical treatment unless specifically directed to do so by their own doctors.

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